COLUMBIA, Mo. – Nearly half of patients taking medications for chronic conditions do not strictly follow their prescribed medication regimens. Failure to use medications as directed increases patients’ risk for side effects, hospitalizations, reduced quality of life and shortened lifespans.

Now, a University of Missouri gerontological nursing expert says patients’ poor adherence to prescribed medication regimens is connected to their beliefs about the necessity of prescriptions and concerns about long-term effects and dependency.

MU Assistant Professor Todd Ruppar found that patients’ beliefs about the causes of high blood pressure and the effectiveness of treatment alternatives significantly affected their likelihood of faithfully following prescribed medication regimens. In his pilot study, Ruppar focused on older patients’ adherence to medication treatments that control high blood pressure, a condition that affects nearly 70 million adults in the U.S. and can lead to heart disease and stroke.

“Often, patients with chronic diseases are prescribed medications but they already have underlying beliefs about the causes of high blood pressure and how it can be treated, which leads them to underuse their medications,” Ruppar said. “For example, some individuals might be able to reduce their blood pressure by walking or cutting down on salt consumption; however, most people need medication to reduce their risk of adverse health outcomes.”

Rather than relying on education approaches, Ruppar says practitioners should aim to amend patients’ behaviors using tactics such as electronic pill bottle caps that alert patients to take medications at specific times or more frequent monitoring of their blood pressure levels so they associate medication adherence with health benefits and non-adherence with negative side effects.

“Patients benefit from objective feedback to see what led them to miss doses, such as varying sleep patterns or weekend schedules. Then, they can change their routines to make taking doses as habitual as brushing their teeth,” Ruppar said. “Self-management is important because encounters with health care providers are fairly short, so as patients, we tend to have better outcomes if we work with our providers to manage our chronic conditions.”

The study, “Medication Beliefs and Antihypertensive Adherence Among Older Adults: A Pilot Study,” was published in Geriatric Nursing. Ruppar is an assistant professor and the John A. Hartford Foundation and Atlantic Philanthropies Claire M. Fagin Fellow in the MU Sinclair School of Nursing. Ruppar’s coauthors include Fabienne Dobbels, an assistant professor at the University of Leuven in Belgium, and Sabina De Geest, a professor at the University of Leuven and the University of Basel in Switzerland.